目的探讨膝关节翻修术治疗膝关节置换(total knee arthroplasty,TKA)术后股骨远端假体周围骨折的可行性和疗效。方法回顾性分析2006年1-12月新疆医科大学第一附属医院收治的因TKA术后股骨远端假体周围骨折行膝关节翻修手术的16例患者资...目的探讨膝关节翻修术治疗膝关节置换(total knee arthroplasty,TKA)术后股骨远端假体周围骨折的可行性和疗效。方法回顾性分析2006年1-12月新疆医科大学第一附属医院收治的因TKA术后股骨远端假体周围骨折行膝关节翻修手术的16例患者资料。术中均采用原膝关节正中切口,使用延长杆固定骨折端,其中3例严重粉碎骨折加用钢板内固定,术中5例采用限制性垫片,其余11例均采用普通垫片。结果所有患者均获得随访,其中4例因其他原因死亡。术后平均随访时间8个月至9年(平均为5.3年)。美国特种外科医院(The Hospital for Special Surgery,HSS)膝关节评分:骨折前平均(91±7.01)分(89~95分),末次随访时平均(85.5±6.18)分(81~90分);膝关节活动度:骨折前平均(115.7±7.6)°(110°~126°),末次随访时平均(101.3±9.8)°(85°~115°)。两者比较差异均无统计学意义。患者均无感染、松动、骨折不愈合等并发症,下肢小腿肌间静脉血栓形成2例。结论膝关节翻修术治疗TKA术后股骨远端假体周围骨折可以获得良好的手术效果,合理正确的手术操作是手术成功的关键,术后随访效果良好。展开更多
AIM To compare infection rates in primary and revision total knee arthroplasty(TKA) procedures using antibiotic impregnated bone cement(AIBC) to those rates in procedures not using AIBC.METHODS A systematic review and...AIM To compare infection rates in primary and revision total knee arthroplasty(TKA) procedures using antibiotic impregnated bone cement(AIBC) to those rates in procedures not using AIBC.METHODS A systematic review and meta-analysis was conducted in search for randomized controlled trials/studies(RCTs) pertaining to the field of antibiotic AIBC vs non-AIBC groups in both primary and revision TKA procedures. The primary literature search performed was to identify all RCTs that assessed AIBC in primary and revision TKA procedures. This search was done strictly through the Pub Med database using the article "filters" setting that identified and separated all RCTs from the overall search. The original search was "Primary/revision total knee arthroplasty using AIBC". Other key terms and phrases were included in the search as well. Eligible articles that were used in the "results" of this review met the following criteria:(1) Involved primary or revision TKA procedures(for any reason);(2) included TKA outcome infection rate information;(3) analyzed an AIBC group vs a non-AIBC control group;(4) were found through the RCT filter or hand search in Pub Med; and(5) published 1985-2017. Exclusion criteria was as follows:(1) Patients that were not undergoing primary or revision TKA procedures;(2) articles that did not separate total hip arthroplasity(THA) vs TKA results if both hip and knee revisions were evaluated;(3) papers that did not follow up on clinical outcomes of the procedure;(4) extrapolation of data was not possible given published results;(5) knee revisions not done on human patients;(6) studies that were strictly done on THAs;(7) articles that were not found through the RCT filter or through hand search in Pub Med;(8) articles that did not evaluate AIBC used in a prosthesis or a spacer during revision;(9) articles that did not compare an AIBC group vs a non-AIBC control group; and(10) articles that were published before 1985.RESULTS In total, 11 articles were deemed eligible for this analysis. Nine of the 11 stud展开更多
文摘目的探讨膝关节翻修术治疗膝关节置换(total knee arthroplasty,TKA)术后股骨远端假体周围骨折的可行性和疗效。方法回顾性分析2006年1-12月新疆医科大学第一附属医院收治的因TKA术后股骨远端假体周围骨折行膝关节翻修手术的16例患者资料。术中均采用原膝关节正中切口,使用延长杆固定骨折端,其中3例严重粉碎骨折加用钢板内固定,术中5例采用限制性垫片,其余11例均采用普通垫片。结果所有患者均获得随访,其中4例因其他原因死亡。术后平均随访时间8个月至9年(平均为5.3年)。美国特种外科医院(The Hospital for Special Surgery,HSS)膝关节评分:骨折前平均(91±7.01)分(89~95分),末次随访时平均(85.5±6.18)分(81~90分);膝关节活动度:骨折前平均(115.7±7.6)°(110°~126°),末次随访时平均(101.3±9.8)°(85°~115°)。两者比较差异均无统计学意义。患者均无感染、松动、骨折不愈合等并发症,下肢小腿肌间静脉血栓形成2例。结论膝关节翻修术治疗TKA术后股骨远端假体周围骨折可以获得良好的手术效果,合理正确的手术操作是手术成功的关键,术后随访效果良好。
基金the University of Toledo College of Medicine and Life Sciences’ Medical Student Summer Research Program
文摘AIM To compare infection rates in primary and revision total knee arthroplasty(TKA) procedures using antibiotic impregnated bone cement(AIBC) to those rates in procedures not using AIBC.METHODS A systematic review and meta-analysis was conducted in search for randomized controlled trials/studies(RCTs) pertaining to the field of antibiotic AIBC vs non-AIBC groups in both primary and revision TKA procedures. The primary literature search performed was to identify all RCTs that assessed AIBC in primary and revision TKA procedures. This search was done strictly through the Pub Med database using the article "filters" setting that identified and separated all RCTs from the overall search. The original search was "Primary/revision total knee arthroplasty using AIBC". Other key terms and phrases were included in the search as well. Eligible articles that were used in the "results" of this review met the following criteria:(1) Involved primary or revision TKA procedures(for any reason);(2) included TKA outcome infection rate information;(3) analyzed an AIBC group vs a non-AIBC control group;(4) were found through the RCT filter or hand search in Pub Med; and(5) published 1985-2017. Exclusion criteria was as follows:(1) Patients that were not undergoing primary or revision TKA procedures;(2) articles that did not separate total hip arthroplasity(THA) vs TKA results if both hip and knee revisions were evaluated;(3) papers that did not follow up on clinical outcomes of the procedure;(4) extrapolation of data was not possible given published results;(5) knee revisions not done on human patients;(6) studies that were strictly done on THAs;(7) articles that were not found through the RCT filter or through hand search in Pub Med;(8) articles that did not evaluate AIBC used in a prosthesis or a spacer during revision;(9) articles that did not compare an AIBC group vs a non-AIBC control group; and(10) articles that were published before 1985.RESULTS In total, 11 articles were deemed eligible for this analysis. Nine of the 11 stud
